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APPLICATION OF WORD PREDICTION SOFTWARE IN PEDIATRIC AND ADULT POPULATIONS

Gene H. Baker, Ed.D.
Charlotte Institute of Rehabilitation
1100 Blythe Blvd.
Charlotte, North Carolina 28203
Voice/Message: (704)355-5867
FAX: (704)355-7873
E-Mail: Web3931@Charweb.org

Web Posted on: November 22, 1997


The abilities to read and write are skills that many take for granted. We use these skills every day as we go through life's routines. Quality of life is altered when one no longer can read or write. It would be difficult to access the world if one never acquired these abilities.

When providing treatment for clients, therapists are often faced with the challenge of finding a way to break through the barriers of illiteracy. The purpose of this paper is to explain a popular word prediction program and show its application in two case studies.

Co:Writer(R) by Don Johnson Incorporated is a writing assistant program that uses intelligent word prediction. When used with a word processing program it allows the client to write and edit at a higher level than otherwise possible. Three sizes of dictionary entries allow the program to be adjusted for beginning writers and more advanced ones. The number of predicted words may be varied (up to nine) to adjust for different needs. Co:Writer uses intelligent prediction to enhance language production of components such as subject/verb agreement, word relationships, proper nouns and user preferences. Co:Writer reads words and sentences as they are typed, thus allowing the client to understand and check what has been written. Auditory reinforcement enables the writer to repeat what has already been written, thus reinforcing memory of original thoughts. The capacity to retain user words in its vocabulary reduces the amount of situational spelling needed. Once a word has been typed, it will be predicted by the first few letters. There is also memory space to code words or phrases and use limited letters to retrieve such words. A pronunciation feature allows for the programming of different dialects so that words are pronounced as the writer expects to hear them.

A word processing program will enable the writer to edit what has been written. If Write:OutLoud(TM) is used, the auditory feedback is consistent throughout and the writer can then listen to the edited passage. There are other word prediction packages on the market. This one has been selected because of the built in features described above. This program has been applied successfully in teaching and re-teaching clients to read and write.

The first case study is that of a forty-nine year old male (John) who was involved in a motor vehicle accident on 9/13/90 and then suffered a CVA on 9/16/90. In 1996, it was also determined that he sustained a traumatic brain injury at the time of the accident. Prior to his accident, John held a full time job, part time job and was in the Reserves of the National Guard. He earned a high school diploma and a two year technical degree from a local community college.

A neuropsychological exam in 1994 stated that John suffered a left middle cerebral artery infarct. Scores on the WAIS-R indicate that he was functioning in the low average range on both performance and verbal subtests. A speech and language evaluation was administered and John was diagnosed as having a mild to moderate non-fluent aphasia. His auditory comprehension was limited to 8 to 12 word sentences, spoken slowly. The speech therapist also diagnosed moderate to severe dyslexia and moderate to severe agraphia. John received speech therapy for approximately one and a half years and was discharged in June of 1992. The speech therapist and the neuropsychologist both felt that John had plateaued. He has received cognitive education therapy since June of 1994. For two years several methods were employed in attempts to increase John's reading and writing skills. Dolch sight words were drilled. John has more difficulty with same words (articles) than with larger words. He often confuses similarly spelled words (ex: that, then, the). Overall, this was ineffective. An attempt was made to teach John basic phonic concepts. He did not learn to read applying phonics initially and therefore this was a difficult concept for him to grasp. When reading, John often "gets ahead of himself", partially reading the words to come. A strategy using a window card was used with some success. Training was implemented in highlighting important words and learning to skip smaller ones that could be understood in context. Initially, John's reading rate was painfully slow. However, over time he was able to increase his rate of reading.

Functional writing is very difficult for John. His ability to spell is greatly diminished. Because of his word finding problems, John repeats items to write over and over and has difficulty focusing on the one word he is trying to write. Writing is difficult as he must write with his non-dominant, left hand due to lack of feeling in his right hand.

When first introduced to the word prediction program, John was not able to perform simple functional tasks such as "To Do" lists or questions to ask during medical appointments. After an initial training period, John was making lists of tasks to be accomplished, supplies needed at the hardware and so forth. Initially, he had difficulty using the prediction feature of the program. He wanted to try to spell things on his own. This slowed him down considerably. At times he was so intense that he simply forgot to use the predicted words. With practice, however, he is now able to use the program as designed to increase rate and accuracy of language production. John is attempting to sound out words that are not readily predicted. He is learning to reword sentences when he gets stuck on a particular word. He also initiated entering content specific words (i.e., medical terms) so that they would be immediately predicted when making a list of questions to ask the physician.

Co:Writer(R) gives immediate feedback. This allows John to independently practice writing skills. This was not the case with conventional methods. John's reading fluency has increased as his skills with word prediction have sharpened. This may be attributed to practice with the program reading aloud to him.

The second case study involves a young girl (Carrie) who had a near drowning incident during the summer of her kindergarten year (1994). She was considered to be normally developing, although she did experience some difficulty with reading readiness skills. After her accident, she was not hospitalized and received no therapy. She experienced seizures and some strange social behaviors that were not present before the accident. She attended public school and was in a regular classroom for first grade. Her behaviors were controlled with medication. Carrie was certified as learning disabled in written expression and received approximately four hours of special education resource during the last half of the school year. She did not progress academically, however, and was retained in the first grade.

A neuropsychological evaluation was conducted in April of 1996. Carrie obtained a Verbal IQ of 67 and Performance IQ of 94. The 26 point discrepancy makes the Full Scale Score of 78 meaningless. Achievement test scores (Woodcock-Johnson-Revised) showed a beginning first grade level in all areas. During the summer of 1996 Carrie was evaluated by a speech therapist who found that she presents with moderate to severe language disorder, severe deficits in problem solving skills and memory.

Carrie received speech therapy, occupational therapy, and cognitive education therapy during the summer of 1996. In October of 1996 she was certified as Other Health Impaired and placed in a self-contained classroom. Carrie had still not mastered reading or writing. In therapy sessions during the summer Carrie was introduced to the word prediction program. The smaller dictionary (2,000 words) was used. Carrie could write simple five to eight word sentences, mostly about her family and experiences. Although she made some progress, her success was impeded by the fact that she only had two opportunities to practice per week. After special placement, the school system made the Co:Writer(R) program available in Carrie's classroom. With daily practice her skills have increased. She knows beginning consonant sounds and is able to spell enough of the word to produce a prediction. Perhaps the most favorable outcome is Carrie extreme pleasure at being able to produce a written product that is all her own. Before using this program her only written products were those she copied after dictating.

Carrie is at a beginning level and currently does not use the word processing program for editing. This will be available to her, however, as her skills grow. At this point it is unclear whether or not Carrie will ever be a functional reader and writer. At this stage in her development, it is reassuring that she understands the purpose of the written word and can participate in classroom activities based around reading and writing.

Although vastly different in profiles, these two clients have increased skills greatly after being trained on word prediction. In both cases traditional methods proved unsuccessful. In John's case it was assumed that his skill level would not change due to the length of time since injury, the amount of speech therapy received and his severe aphasia. He is often frustrated by the aphasia and severe word finding problems. When sitting at the computer alone, however, he is able to formulate his thoughts and get them down in writing. The pressure of being understood is lessened and his success is increased. For Carrie, time and practice are of utmost importance. Educational decisions will have to be re-evaluated constantly as she progresses through the school years.